Review Article

Screening for Prostate Cancer: The Debate Continues

Marc R. Matrana, MD, MS, and Bradley Atkinson, PharmD

From University of Texas MD Anderson Cancer Center, Houston, Texas

The authors have no conflicts of interest to disclose.

Correspondence to: Marc R. Matrana, MD, MS, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 463, Houston, TX 77030. E-mail: mrmatrana@mdanderson.org


J Adv Pract Oncol 2013;4:16–21 | DOI: 10.6004/jadpro.2013.4.1.2 | © 2013 Harborside Press®


  

ABSTRACT

Other than skin cancer, prostate cancer is the most frequently diagnosed cancer in men, and it is the second leading cause of cancer-related death for males in the United States. Screening for prostate cancer using prostate-specific antigen testing became widely used by the late 1980s, augmenting the digital rectal exam. This led to a decline in the percentage of prostate cancer cases that were metastatic at diagnosis and a decrease in prostate cancer mortality. But some argued it led to overtreatment of prostate cancers as well. Recently, the U.S. Preventive Services Task Force (USPSTF) issued recommendations against routine prostate cancer screening in asymptomatic patients. The recent recommendations have created much controversy among medical professionals, patient advocate groups, and the general public. Most prostate cancer screening recommendations from professional organizations agree that an informed discussion and review of each individual patient’s clinical situation should drive the decision to screen or not to screen, but the current USPSTF recommendations largely remove patient and provider autonomy in this regard. They do not contribute toward personalized screening based on individualized patient risk profiles, characteristics, and preferences. 




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